title: Preoperative plasma D-dimer levels predict survival in patients with operable non-small cell lung cancer independently of venous thromboembolism.
abstract: OBJECTIVE
  D-dimer is a stable end product of fibrin degradation that is associated with advanced tumor stage and poor prognosis in lung cancer patients. Venous thromboembolism (VTE) is a frequent complication of cancer and is associated with a poor prognosis in cancer patients. The purpose of the study is to elucidate whether the increased mortality in non-small cell lung (NSCLC) patients with elevated D-dimer levels is independent of VTE.
  
  
  METHODS
  A retrospective review was conducted of 232 patients with operable NSCLC from January 2007 to June 2008. All the patients underwent a pneumonectomy, lobectomy or wedge resection. We assessed the ability of preoperative plasma D-dimer levels to predict 1-year mortality and overall survival among them, and a multivariable Cox proportional-hazard regression analysis was performed after controlling for the following potential confounding factors: age, gender, TNM stage, histology, tumor size, VTE and surgical interventions.
  
  
  RESULTS
  The overall 1-year survival rate was 91.4% (95% confidence interval (CI), 82.7-94.8%), with a 76.5% survival (95% CI, 71.4-81.6%) in the high D-dimer group and a 93.9% survival (95% CI, 86.4-97.9%) in the normal D-dimer group. Comparing the high D-dimer group with the normal D-dimer group, the adjusted hazard ratio for 1-year mortality and overall survival was 3.19 (95% CI, 1.18-7.12) and 1.54 (95% CI, 1.11-2.78) respectively.
  
  
  CONCLUSIONS
  Our study concluded that the preoperative plasma D-dimer level is an important prognostic biomarker in patients with operable NSCLC that is independent of VTE.
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Tumor Institute and Hospital, Tianjin Lung Cancer Diagnosis and Treatment Centre, Tianjin 300060, China; Department of Radiotherapy, Hubei Cancer Hospital, 430079 Wuhan, China.
authors.forename: P P
authors.initials: PP
authors.lastname: Zhang
authors.forename: J W
authors.initials: JW
authors.lastname: Sun
authors.forename: X Y
authors.initials: XY
authors.lastname: Wang
authors.forename: X M
authors.initials: XM
authors.lastname: Liu
authors.forename: K
authors.initials: K
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000401:mortality / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D054556:Venous Thromboembolism / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: D-dimer; Non-small cell lung cancer; Operable; Prognosis; Venous thromboembolism